Results from the INMUNOSUN-SOGUG trial: a prospective phase II study of sunitinib as a second-line therapy in patients with metastatic renal cell carcinoma after immune checkpoint-based combination therapy.

BACKGROUND: The INMUNOSUN trial had the objective of prospectively evaluating the efficacy and safety of sunitinib as a pure second-line treatment in patients with metastatic renal cell carcinoma (mRCC) who have progressed to first-line immune checkpoint inhibitor (ICI)-based therapies. PATIENTS AND METHODS: A multicenter, phase II, single-arm, open-label study was carried out in patients with a histologically confirmed diagnosis of mRCC with a clear-cell component who had progressed to a first-line regimen of ICI-based therapies. All patients received sunitinib 50 mg once daily orally for 4 weeks, followed by a 2-week rest period following package insert instructions. The primary outcome was the objective response rate. RESULTS: Twenty-one assessable patients were included in the efficacy and safety analyses. Four patients [19.0%, 95% confidence interval (CI) 2.3% to 35.8%] showed an objective response (OR), and all of them had partial responses. Additionally, 14 (67%) patients showed a stable response, leading to clinical benefit in 18 patients (85.7%, 95% CI 70.7% to 100%). Among the four assessable patients who showed an OR, the median duration of the response was 7.1 months (interquartile range 4.2-12.0 months). The median progression-free survival (PFS) was 5.6 months (95% CI 3.1-8.0 months). The median overall survival (OS) was 23.5 months (95% CI 6.3-40.7 months). Patients who had better antitumor response to first-line ICI-based treatment showed a longer PFS and OS with sunitinib. The most frequent treatment-emergent adverse events were diarrhea (n = 11, 52%), dysgeusia (n = 8, 38%), palmar-plantar erythrodysesthesia (n = 8, 38%), and hypertension (n = 8, 38%). There was 1 patient who exhibited grade 5 pancytopenia, and 11 patients experienced grade 3 adverse events. Eight (38%) patients had serious adverse events, four of which were considered to be related to sunitinib. CONCLUSION: Although the INMUNOSUN trial did not reach the pre-specified endpoint, it demonstrated that sunitinib is active and can be safely used as a second-line option in patients with mRCC who progress to new standard ICI-based regimens.

[Differences and similarities between the competencies of a nursing supervisor and an advanced clinical nurse specialist]. / Diferencias y similitudes entre las competencias de una supervisora de enfermería y una enfermera clínica especialista.

INTRODUCTION: With the aim of contributing to the development of a more specific professional regulation, the present study was to identify differences and similarities between the competencies of the nursing supervisor and clinical nurse specialist in an intensive care unit. MATERIAL AND METHODS: A critical analysis of the literature published between 2003 and 2013 was conducted, identified through systematic searches in electronic databases, health management and practitioner journals and reference lists of the 17 items included. RESULTS: «Management and administration¼ and «direct clinical practice¼ were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration¼, «leadership¼ and «research¼ emerged as competencies shared by both profiles, but with different a operationalization way of conducting it. CONCLUSIONS: These findings imply that regulation, education and implementation of these profiles must address their specific skills as the distinctive approach taken in operationalizing shared.

Usefulness of bone turnover markers as predictors of mortality risk, disease progression and skeletal-related events appearance in patients with prostate cancer with bone metastases following treatment with zoledronic acid: TUGAMO study.

BACKGROUND: Owing to the limited validity of clinical data on the treatment of prostate cancer (PCa) and bone metastases, biochemical markers are a promising tool for predicting survival, disease progression and skeletal-related events (SREs) in these patients. The aim of this study was to evaluate the predictive capacity of biochemical markers of bone turnover for mortality risk, disease progression and SREs in patients with PCa and bone metastases undergoing treatment with zoledronic acid (ZA). METHODS: This was an observational, prospective and multicenter study in which ninety-eight patients were included. Patients were treated with ZA (4 mg every 4 weeks for 18 months). Data were collected at baseline and 3, 6, 9, 12, 15 and 18 months after the beginning of treatment. Serum levels of bone alkaline phosphtase (BALP), aminoterminal propeptide of procollagen type I (P1NP) and beta-isomer of carboxiterminal telopeptide of collagen I (ß-CTX) were analysed at all points in the study. Data on disease progression, SREs development and survival were recorded. RESULTS: Cox regression models with clinical data and bone markers showed that the levels of the three markers studied were predictive of survival time, with ß-CTX being especially powerful, in which a lack of normalisation in visit 1 (3 months after the beginning of treatment) showed a 6.3-times more risk for death than in normalised patients. Levels of these markers were also predictive for SREs, although in this case BALP and P1NP proved to be better predictors. We did not find any relationship between bone markers and disease progression. CONCLUSION: In patients with PCa and bone metastases treated with ZA, ß-CTX and P1NP can be considered suitable predictors for mortality risk, while BALP and P1NP are appropriate for SREs. The levels of these biomarkers 3 months after the beginning of treatment are especially important.

Biochemical markers of bone turnover and clinical outcome in patients with renal cell and bladder carcinoma with bone metastases following treatment with zoledronic acid: The TUGAMO study.

BACKGROUND: Levels of bone turnover markers (BTM) might be correlated with outcome in terms of skeletal-related events (SRE), disease progression, and death in patients with bladder cancer (BC) and renal cell carcinoma (RCC) with bone metastases (BM). We try to evaluate this possible correlation in patients who receive treatment with zoledronic acid (ZOL). METHODS: This observational, prospective, and multicenter study analysed BTM and clinical outcome in these patients. Serum levels of bone alkaline phosphatase (BALP), procollagen type I amino-terminal propeptide (PINP), and beta-isomer of carboxy-terminal telopeptide of type I collagen (ß-CTX) were analysed. RESULTS: Patients with RCC who died or progressed had higher baseline ß-CTX levels and those who experienced SRE during follow-up showed high baseline BALP levels. In BC, a poor rate of survival was related with high baseline ß-CTX and BALP levels, and new SRE with increased PINP levels. Cox univariate analysis showed that ß-CTX levels were associated with higher mortality and disease progression in RCC and higher mortality in BC. Bone alkaline phosphatase was associated with increased risk of premature SRE appearance in RCC and death in BC. CONCLUSION: Beta-isomer of carboxy-terminal telopeptide of type I collagen and BALP can be considered a complementary tool for prediction of clinical outcomes in patients with BC and RCC with BM treated with ZOL.

[The role of occupational context factors in medication administration errors]. / Factores del entorno de trabajo que influyen en la ocurrencia de errores de administración de medicación.

BACKGROUND: The incidence of medication administration errors (MAE) is high and costly for patients and health institutions. Human factors and factors relating to the work context intervene in their occurrence. The aim of this article is to identify the role of factors in the work setting related to occurrence of MAEs in the hospital field. METHODS: A narrative review of the literature. Eight articles were included following a review of MEDLINE, CINAHL and COCHRANE LIBRARY databases for the 2002-2012 period. RESULTS: Distractions and interruptions, work overload, design of units and characteristics of the material stood out amongst the work context factors intervening in the occurrence of medication administration errors. CONCLUSIONS: The creation of organizational artefacts to reduce interruptions; patient involvement in medication administration; the introduction of new technologies and improving the labelling of medications can help reduce the incidence of medication administration errors. To advance in identifying and managing factors that are precursors of medication administration errors, we recommend the carrying out of studies or reviews of prospective cohorts.

Daily consumption of foods and nutrients from institutional and home sources among young children attending two contrasting day-care centers in Guatemala City

Adequate nutrition is critical to child development and institutions such as day-care centers could potentially complement children’s diets to achieve optimal daily intakes. The aim of the study was to describe the full-day diet of children, examining and contrasting the relative contribution of home-derived versus institutional energy and nutrient sources. The present comparison should be considered in the domain of a case-study format. The diets of 33, 3-6 y old children attending low-income day-care centers serving either 3 or a single meal were examined. The home-diet was assessed by means of 3 non-consecutive 24-hr recalls. Estimated energy and nutrient intakes at the centers and at home were assessed and related to Recommended Nutrient Intakes (RNI). Nutrient densities, critical densities and main sources of nutrients were computed. We observed that in children attending the day-care center serving three meals, home-foods contributed less than half the daily energy (47.7%) and between 29.9% and 53.5% of daily nutrients. In children receiving only lunch outside the home, energy contribution from the home was 83.9% and 304 kcal lower than for children receiving 3 meals. Furthermore, between 59.0% and 94.8% of daily nutrients were provided at home. Daily energy, nutrient intakes and nutrient densities were well above the nutrient requirements for this age group, and particularly high for vitamin A. The overall dietary variety was superior in the situation of greater contribution of home fare, but overall the nutrient density and adequacy of the aggregate intakes did not differ in any important manner.

Ingesta diaria de alimentos y nutrientes provenientes de la dieta institucional y del hogar en niños que asisten a dos centros de cuidado infantil contrastantes en la ciudad de Guatemala. Una adecuada nutrición es crítica para el desarrollo infantil. Los centros de cuidado infantiles (CCI) podrían jugar un papel fundamental en la complementación de la ingesta de alimentos y nutrientes. El propósito de este estudio fue describir la dieta de niños, comparando la contribución relativa de energía y nutrientes de la dieta-hogar e institucional. El presente estudio debe ser considerado como una presentación de caso. Se examinó la dieta de 33 niños de 3-6 años que asisten a dos CCI utilizados por familias de escasos recursos y con diferencias en número de comidas servidas. Se determinó la dieta-hogar utilizando 3 recordatorios de 24-horas en días no-consecutivos. Se calculó la ingesta estimada de energía y nutrientes en las instituciones y en casa y se comparó con las Ingestas Recomendadas de Nutrientes. Se determinó la densidad de nutrientes y principales fuentes. Se observó que los alimentos consumidos en el hogar contribuyeron 47.7% de la energía diaria y entre 29.9% y 53.5% de los nutrientes diarios requeridos para los niños con 3 comidas en el CCI y de 83.9%, 59.0 y 94.8%, respectivamente, para los niños que consumen únicamente el almuerzo en el CCI. La ingesta diaria de energía fue 304 kcal mayor en los niños que consumieron 3 comidas fuera del hogar. No hubo mayor variación en las dietas cuando mayor era el consumo de alimentos en el hogar, sin embargo la densidad nutricional y la adecuación de la dieta completa fue adecuada en ambos centros, y particularmente elevadas para la vitamina A.

[Blue rubber bleb nevus syndrome: A case report]. / Síndrome de nevos azules ahulados: reporte de un caso.

Blue Rubber Bleb Nevus Syndrome (BRBS) is a rare disease, characterized by multiple vascular malformations in the skin and gastrointestinal tract. Other organs can also be affected, presenting different clinical manifestations such as arthralgia, epistaxis, hemoptysis, hematuria, hemothorax, mild thrombocytopenia, consumptive coagulopathy, and bone deformities, among others. We present a case of BRBS in a nine-year-old boy with the characteristic clinical manifestations of punctated purplish-blue skin lesions that vary in size and gastrointestinal vascular malformations with upper digestive tract bleeding.

Pseudocollinia brintoni gen. nov., sp. nov. (Apostomatida: Colliniidae), a parasitoid ciliate infecting the euphausiid Nyctiphanes simplex.

A novel parasitoid ciliate, Pseudocollinia brintoni gen. nov., sp. nov. was discovered infecting the subtropical sac-spawning euphausiid Nyctiphanes simplex off both coasts of the Baja California peninsula, Mexico. We used microscopic, and genetic information to describe this species throughout most of its life cycle. Pseudocollinia is distinguished from other Colliniidae genera because it exclusively infects euphausiids, has a polymorphic life cycle, and has a small cone-shaped oral cavity whose left wall has a field of ciliated kinetosomes and whose opening is surrounded on the left and right by 2 'oral' kineties (or ciliary rows) that terminate at its anterior border. Two related species that infect different euphausiid species from higher latitudes in the northeastern Pacific Ocean, Collinia beringensis Capriulo and Small, 1986, briefly redescribed herein, and Collinia oregonensis Gómez-Gutiérrez, Peterson, and Morado, 2006, are transferred to the genus Pseudocollinia. P. brintoni has between 12 and 18 somatic kineties, and its oral cavity has only 2 oral kineties, while P. beringensis comb. nov. has more somatic kineties, including 3 oral kineties. P. oregonensis comb. nov. has an intermediate number of somatic kineties. P. beringensis comb. nov. also infects Thysanoessa raschi (a new host species). SSU rRNA and cox1 gene sequences demonstrated that Pseudocollinia ciliates are apostome ciliates and that P. brintoni is different from P. beringensis comb. nov. High densities of rod-shaped bacteria (1.7 µm length, 0.2 to 0.5 µm diameter) were associated with P. brintoni. After euphausiid rupture, high concentrations of P. brintoni and bacteria cluster to form 3 to 6 cm long filaments where tomites encyst and transform to the phoront stage; this is a novel place for encystation. P. brintoni may complete its life cycle when the euphausiids feed on these filaments.

Daily consumption of foods and nutrients from institutional and home sources among young children attending two contrasting day-care centers in Guatemala City.

Adequate nutrition is critical to child development and institutions such as day-care centers could potentially complement children's diets to achieve optimal daily intakes. The aim of the study was to describe the full-day diet of children, examining and contrasting the relative contribution of home-derived versus institutional energy and nutrient sources. The present comparison should be considered in the domain of a case-study format. The diets of 33, 3-6 y old children attending low-income day-care centers serving either 3 or a single meal were examined. The home-diet was assessed by means of 3 non-consecutive 24-hr recalls. Estimated energy and nutrient intakes at the centers and at home were assessed and related to Recommended Nutrient Intakes (RNI). Nutrient densities, critical densities and main sources of nutrients were computed. We observed that in children attending the day-care center serving three meals, home-foods contributed less than half the daily energy (47.7%) and between 29.9% and 53.5% of daily nutrients. In children receiving only lunch outside the home, energy contribution from the home was 83.9% and 304 kcal lower than for children receiving 3 meals. Furthermore, between 59.0% and 94.8% of daily nutrients were provided at home. Daily energy, nutrient intakes and nutrient densities were well above the nutrient requirements for this age group, and particularly high for vitamin A. The overall dietary variety was superior in the situation of greater contribution of home fare, but overall the nutrient density and adequacy of the aggregate intakes did not differ in any important manner.

Phase II open-label study of erlotinib in combination with gemcitabine in unresectable and/or metastatic adenocarcinoma of the pancreas: relationship between skin rash and survival (Pantar study).

BACKGROUND: Skin rash is an adverse event which might be associated with longer survival in patients treated with epidermal growth factor receptor tyrosine kinase inhibitors. The aim of this nonrandomised phase II clinical trial is to prospectively evaluate the relationship between skin rash and overall survival (OS) in advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine. PATIENTS AND METHODS: Patients were given gemcitabine (1000 mg/m2/week, 3 weeks every 4 weeks) plus erlotinib (100 mg/day orally continuously) until disease progression/unacceptable toxicity. The primary end point was OS. RESULTS: A total of 153 eligible patients were enrolled (grade≥2 rash, 25%; grade<2 rash, 75%). OS was longer in patients with grade≥2 rash versus grade<2 (11 versus 5 months; P<0.001). Progression-free survival was longer in patients with grade≥2 rash versus grade<2 (6 versus 3 months; P<0.001) and shorter in those without rash versus grade 1 (2 versus 4 months; P=0.005) or grade≥2 (2 versus 6 months; P<0.001). Patients with grade≥2 rash showed higher rates of overall response (21% versus 7%; P<0.05) and disease control (84% versus 43%; P<0.05) versus grade<2. CONCLUSIONS: This study prospectively confirms the relationship between rash and longer OS in unresectable locally advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine.

[Normal physiological variations of pubertal development: starting age of puberty, menarcheal age and size]. / Variaciones fisiológicas normales del desarrollo puberal: edad del inicio puberal, edad de la menarquia y talla.

OBJECTIVES: To evaluate the impact of early, mid-onset, and late maturation, assessed by the age at menarche, height at the beginning of puberty, time of menarche, at one and two years after menarche in a group of healthy girls. The time lapse between the start of puberty and the advent of menarche was observed in that group of girls. To investigate whether their weight status (body mass index) is causally implicated in early start of puberty in these girls. PATIENTS AND METHODS: A prospective observational study was performed on 266 healthy Caucasian girls, who were followed up with visits at the beginning of puberty, at menarche and then every six months. Physical examinations included height, weight and pubertal stages, and were assessed by clinical examination according to methods of Tanner. The statistical analysis was performed using the SPSS 12.0 package. RESULTS: We found that mean age of breast development 2 (B2) was 10.72 years and mean menarcheal age was 12.43 years. The correlation coefficient (r) between the onset of puberty and its duration was r = -0.406 (p < 0.01), and that of age of pubertal onset versus age of menarche was r = 0.34 (p < 0.01). According to 25th and 80th percentiles, early matures were shorter at onset of puberty, at menarche and two years later. Post-menarcheal increase in stature was greatest in early maturers. There is also a correlation between the "z" score of body mass index and the age at onset of puberty (r = -0.398). CONCLUSIONS: The puberty began at 10.72 years, the menarche appears at 12.43 as average. Girls who matured early were shorter at onset, at menarche and two years after, despite having greater peak height velocity and post-menarcheal increase in height. The age of menarche correlated with the "z" score of body mass index.

Variaciones fisiológicas normales del desarrollo puberal: edad del inicio puberal, edad de la menarquia y talla / Normal physiological variations of pubertal development: starting age of puberty, menarcheal age and size

Objetivos: Evaluar el impacto F de una maduración adelantada, promedio y tardía, de acuerdo con la edad de la menarquia, en la talla al comienzo de la pubertad, en el momento de la menarquia, 1 y 2 años después de la menarquia en un grupo de niñas sanas. Observar la duración de la pubertad, el tiempo transcurrido desde su inicio y la aparición de la menarquia en dicho grupo de niñas. Investigar si el índice de masa corporal guarda alguna relación con el inicio puberal y la menarquia. Pacientes y métodos: Se ha realizado un estudio observacional prospectivo en 266 niñas sanas. Todas las niñas son de raza blanca, fueron exploradas en visitas programadas antes del inicio puberal, al comienzo del desarrollo puberal (estadio B2 del desarrollo mamario), en el mes que tuvieron la menarquia y después cada 6 meses. Resultados: Encontramos una edad media de desarrollo mamario (B2) de 10,72 años y una edad media de la menarquia de 12,43 años. Existe una correlación significativa negativa (r: -0,406) entre el inicio puberal (B2) y su duración, y una correlación positiva (r: 0,34) entre las edades del inicio puberal y de la menarquia. De acuerdo con los percentiles 25 y 80, las maduradoras adelantadas eran más bajas al inicio puberal, en la menarquia y 2 años más después de ésta. El incremento en la estatura tras la menarquia fue mayor en las maduradoras adelantadas. Hay una correlación negativa entre la puntuación "z" del índice de masa corporal y el inicio de la pubertad (r: -0,398). Conclusiones: La pubertad se inició a una edad media de 10,72 años, y la menarquia, a los 12,43 años. Las niñas maduradoras adelantadas presentaron una talla inferior al inicio puberal, en la menarquia y 2 años después de la menarquia en relación con las otras niñas en estos mismos acontecimientos puberales, y tuvieron un mayor incremento de la talla tras la menarquia que las otras niñas. La edad de la menarquia se correlaciona con la puntuación "z" del índice de masa corporal

Objectives: To evaluate the impact of early, mid-onset, and late maturation, assessed by the age at menarche, height at the beginning of puberty, time of menarche, at one and two years after menarche in a group of healthy girls. The time lapse between the start of puberty and the advent of menarche was observed in that group of girls. To investigate whether their weight status (body mass index) is causally implicated in early start of puberty in these girls. Patients and methods: A prospective observational study was performed on 266 healthy Caucasian girls, who were followed up with visits at the beginning of puberty, at menarche and then every six months. Physical examinations included height, weight and pubertal stages, and were assessed by clinical examination according to methods of Tanner. The statistical analysis was performed using the SPSS 12.0 package. Results: We found that mean age of breast development 2 (B2) was 10.72 years and mean menarcheal age was 12.43 years. The correlation coefficient (r) between the onset of puberty and its duration was r -0.406 (p < 0.01), and that of age of pubertal onset versus age of menarche was r 0.34 (p < 0.01). According to 25th and 80th percentiles, early matures were shorter at onset of puberty, at menarche and two years later. Post-menarcheal increase in stature was greatest in early maturers. There is also a correlation between the "z" score of body mass index and the age at onset of puberty (r -0.398). Conclusions: The puberty began at 10.72 years, the menarche appears at 12.43 as average. Girls who matured early were shorter at onset, at menarche and two years after, despite having greater peak height velocity and post-menarcheal increase in height. The age of menarche correlated with the "z" score of body mass index

Determinantes de la satisfacción laboral en trabajadores de la administración pública: el valor de las relaciones interpersonales en el lugar de trabajo / Determinants of job satisfaction in public administration workers: the value of interpersonal relations in workplace

Son muy numerosas las investigaciones que analizan las variables implicadas en la explicación de la satisfacción laboral, aunque las conclusiones a las que llegan no son coincidentes, debidO a que determinadas condiciones del lugar de trabajo no provocan los mismos efectos en todos los contextos analizados. Esta relación difiere en función del grupo de trabajadores que esté siendo analizado (profesionales de la salud, empleados del sector público, empleados municipales, etc.). Igualmente, existe cierta evidencia que apoya el papel de las relaciones interpersonales en el bienestar de los empleados (Noblet, 2003). El presente estudio, centrado en un contexto laboral específico -la Administración Pública- examina la relación entre condiciones de trabajo, apoyo social percibido (incluyendo dos fuentes de apoyo: compañeros y superior inmediato), reciprocidad percibida y satisfacción laboral en 294 empleados de la Administración de Justicia de la Junta de Andalucía. Los resultados revelan que las variables ligadas a las relaciones interpersonales, especialmente el apoyo social, la reciprocidad y la ausencia de conflictos interpersonales, así como las relativas al desarrollo profesional tienen un peso importante en la proporción de varianza explicada de la satisfacción laboral

There is extensive research literature about the variables that explain job satisfaction, but the same workplace dimensions are not systematically related to satisfaction in the ditTerent work settings. This relation may differ depending on the group under study (health workers, employees of public sector, municipal government employees, etc.). However, there is some evidence supporting the role of interpersonal relationships in promoting employees' well-being (Noblet, 2003). The present study focused on a specific job context -the Public Administration- examines the relationships between work characteristics, perceived social support (including two sources: coworkers and supervisor), perceived reciprocity and job satisfaction in 294 justice government employees. The results revealed that the work characteristics related to interpersonal relationships, particularly social support, reciprocity and absence of interpersonal conflicts, as well as professional development, accounted for optimal proportions of explained variance in job satisfaction

The quotient of number of nodes and tumour size (N/T) from primary breast cancer predicts the clinical course after diagnosis of distant relapse.

INTRODUCTION: Breast cancer is a disease with a very variable progression. Primary tumour size and metastatic lymph node involvement are the best indicators of the likelihood of relapse. However, their value in predicting progression following relapse is not clear. AIM: The aim of this study was to asses whether the relationship between tumour size and the number of lymph nodes involved had any value as predictive factors of post-relapse progression. METHOD: We established an index defined as the quotient between the number of diseased lymph nodes and the tumour size (in cm). RESULTS: Applying this index in 230 consecutive patients with metastatic breast cancer, we observed that there was a significant inverse relation between the index and post-relapse progression. CONCLUSION: We conclude that, at the time of initial diagnosis, the quotient of tumour size and the number of diseased lymph nodes could be a good predictor of time-to-progression following the diagnosis of the metastatic disease.

Prevalencia de hemocromatosis en trabajadores sanos. Importancia de añadir en la analítica de perfil bioquímico una saturación de transferrina / Prevalence of hereditary hemochromatosis among healthy workers: diagnostic value of transferrin saturation assay

Objetivo: La hemocromatosis es la enfermedad genética más común en la población blanca (dos a ocho casos por mil habitantes). Está caracterizada por una absorción excesiva de hierro, que conlleva a un acúmulo del mismo en diversos órganos. Su diagnóstico precoz, con la instauración de sangrías periódicas, condiciona que estos enfermos puedan igualarse a la población sana, tanto en calidad de vida como en sobrevivencia. Esto hace muy aconsejable la realización de despistaje de esta enfermedad en la población aparentemente sana. Aunque se han hecho grandes avances en los estudios genéticos de esta población, sigue siendo una saturación de transferrina (ST) elevada (superior a 60 porciento) el test más utilizado para iniciar una aproximación diagnóstica de la enfermedad. Nosotros realizamos ST a un grupo de trabajadores sanos para confirmar en nuestro medio la utilidad de este test en el diagnóstico de hemocromatosis. Método: Estudio prospectivo sobre 1.131 trabajadores activos que acuden a una revisión anual a un Centro Oficial de Seguridad e Higiene, practicándoseles a todos ST. Si ésta resulta elevada son derivados a un Centro Hospitalario para continuar con la aproximación diagnóstica de la hemocromatosis. Resultados: La ST resultó elevada en 22 trabajadores, de los cuales son estudiados 21 en un Centro Hospitalario. En once se normaliza la ST después de abstinencia de alcohol o al repetir el análisis. A nueve se les propone biopsia hepática, realizándose en seis. De estos seis se confirmó la hemocromatosis en tres, lo que hace una prevalencia confirmada, al menos, de 2.6 por mil habitantes. Conclusiones: Creemos que la saturación de transferrina es útil para iniciar el despistaje de hemocromatosis y que debería imponerse como parte del perfil bioquímico de analítica rutinaria. Otros métodos diagnósticos menos engorrosos que la biopsia hepática son necesarios para confirmar la enfermedad (AU)

[Prevalence of hereditary hemochromatosis among healthy workers. Diagnostic value of transferrin saturation assay]. / Prevalencia de hemocromatosis en trabajadores sanos. Importancia de añadir en la analítica de perfil bioquímico una saturación de transferrina.

AIM: Hereditary hemochromatosis is the most common inherited disorder in white population (2-8 cases per 1000 habitants). Hemochromatosis is characterized by increased intestinal absorption of iron leading to its deposition into multiple organs. An early diagnosis and proper management with frequent phlebotomies are known to improve life expectancy and quality of life. Diagnosis is suggested by an elevated Transferrin saturation (TS) (more than 60%). METHOD: Prospective study of the level of TS among 1131 healthy workers, who came to the Security and Hygiene Official Centre for their annual revision had been undertaken. RESULTS: Twenty-wo workers had high TS; in 10 of them the increase of TS was confirmed on repeated determinations. Liver biopsy was performed in six (and refused by the other four), eventually a diagnosis of hemochromatosis was confirmed in three (in-group prevalence of 2.6 per 1000 people). CONCLUSIONS: In our experience, TS is the most appropriate initial screening test for detecting hereditary hemochromatosis in a normal population.